Cassilly Daniel W, Wang Y Richard, Friedenberg Frank K, Nelson Deborah B, Maurer Alan H, Parkman Henry P
Gastrointestinal Section, Department of Medicine, Temple University, Philadelphia, PA 19140, USA.
Digestion. 2008;78(2-3):144-51. doi: 10.1159/000175836. Epub 2008 Nov 22.
BACKGROUND/AIM: The Gastroparesis Cardinal Symptom Index (GCSI) was developed to assess symptoms of gastroparesis. The aim of this study was to correlate symptoms using the GCSI with delayed gastric emptying (DGE) in symptomatic patients referred for gastric emptying scintigraphy (GES).
A total of 226 consecutive symptomatic patients referred for GES completed the 9-question GCSI. GES was performed using a (99)Tc-labeled egg meal. Gastroparesis was defined as DGE at 2 h and/or 4 h.
Using linear regression, nausea (p = 0.09), not able to finish a normal-size meal (p = 0.005), postprandial fullness subscore (p = 0.01), and total GCSI score (p = 0.06) were predictors of the gastric retention values at 2 h, but not at 4 h. Patients with gastroparesis had significant higher symptom scores for nausea (p = 0.035) and vomiting (p = 0.040) compared to patients with normal gastric emptying. The positive predictive value varied between 51 and 61% for total GCSI scores between 20 and 35, respectively.
The individual symptoms of nausea, vomiting, and early satiety were associated with DGE at 2 h but not at 4 h. In contrast, the total or average GCSI score did not reliably predict the diagnosis of gastroparesis in symptomatic patients referred for GES.
背景/目的：胃轻瘫主要症状指数（GCSI）用于评估胃轻瘫症状。本研究旨在将有症状患者中使用GCSI得出的症状与胃排空闪烁扫描（GES）检查时的胃排空延迟（DGE）进行关联。
共有226例连续的因GES检查而转诊的有症状患者完成了9个问题的GCSI问卷。使用（99）Tc标记的鸡蛋餐进行GES检查。胃轻瘫定义为2小时和/或4小时时的胃排空延迟。
采用线性回归分析，恶心（p = 0.09）、无法吃完正常量餐食（p = 0.005）、餐后饱胀子评分（p = 0.01）和GCSI总分（p = 0.06）是2小时时胃潴留值的预测因素，但不是4小时时的预测因素。与胃排空正常的患者相比，胃轻瘫患者的恶心（p = 0.035）和呕吐（p = 0.040）症状评分显著更高。GCSI总分在20至35之间时，阳性预测值分别在51%至61%之间。
恶心、呕吐和早饱等个体症状与2小时时的胃排空延迟相关，但与4小时时的胃排空延迟无关。相比之下，GCSI总分或平均分不能可靠地预测因GES检查而转诊的有症状患者的胃轻瘫诊断。
